Knowledge and practice of exclusive breastfeeding among women with children aged between 9 and 12 months in Al-Sabah Children Hospital, Juba, South Sudan

Introduction: Breastfeeding is an important tool for preventing childhood illnesses, and obesity, and hypertension later on in life, and it reduces the cost of food for the family and the country. Appropriate practices that support exclusive breastfeeding in the first six months reduce childhood morbidity and mortality.Methodology: 384 mothers with children aged 9 to 12 months attending the immunization and paediatric outpatient clinics were interviewed. Statistical Package for Social Sciences (SPSS) was used for data handling. Descriptive statistics and univariate logistic regression were used to analyse the data.Results: The majority of mothers were aged between 21 – 25 years (43.5%), had 2 - 4 children (55.5%) and primary education (48.2%). Most mothers had started breastfeeding within the first hour of delivery (76.8%), and knew that breastfeeding was nutritious to the baby. Parity and mother`s level of education were significant factors associated with exclusive breastfeeding (p<0.05). There was no statistically significant association between occupation, age of the mother, mode of delivery and exclusive breastfeeding (p>0.05). There was no statistical difference in rate of exclusive breastfeeding in mothers attending the OPD and the immunization clinic (p value=0.09).Conclusion: Most mothers knew the benefits and definitions of exclusive  breastfeeding. The early measures supporting breastfeeding are well practiced. Parity and mothers` education significantly affected exclusive breastfeeding.Keys words: Exclusive breast feeding, child, nutritio

The role of neutralizing antibodies in prevention of HIV-1 infection: what can we learn from the mother-to-child transmission context?

International audienceIn most viral infections, protection through existing vaccines is linked to the presence of vaccine-induced neutralizing antibodies (NAbs). However, more than 30 years after the identification of AIDS, the design of an immunogen able to induce antibodies that would neutralize the highly diverse HIV-1 variants remains one of the most puzzling challenges of the human microbiology. The role of antibodies in protection against HIV-1 can be studied in a natural situation that is the mother-to-child transmission (MTCT) context. Indeed, at least at the end of pregnancy, maternal antibodies of the IgG class are passively transferred to the fetus protecting the neonate from new infections during the first weeks or months of life. During the last few years, strong data, presented in this review, have suggested that some NAbs might confer protection toward neonatal HIV-1 infection. In cases of transmission, it has been shown that the viral population that is transmitted from the mother to the infant is usually homogeneous, genetically restricted and resistant to the maternal HIV-1-specific antibodies. Although the breath of neutralization was not associated with protection, it has not been excluded that NAbs toward specific HIV-1 strains might be associated with a lower rate of MTCT. A better identification of the antibody specificities that could mediate protection toward MTCT of HIV-1 would provide important insights into the antibody responses that would be useful for vaccine development. The most convincing data suggesting that NAbs migh confer protection against HIV-1 infection have been obtained by experiments of passive immunization of newborn macaques with the first generation of human monoclonal broadly neutralizing antibodies (HuMoNAbs). However, these studies, which included only a few selected subtype B challenge viruses, provide data limited to protection against a very restricted number of isolates and therefore have limitations in addressing the hypervariability of HIV-1. The recent identification of highly potent second-generation cross-clade HuMoNAbs provides a new opportunity to evaluate the efficacy of passive immunization to prevent MTCT of HIV-1

Knowledge and practice of exclusive breastfeeding among women with children aged between 9 and 12 months in Al Sabah Hospital, Juba, South Sudan

Introduction: Breastfeeding is an important tool for preventing childhood illnesses, and obesity, and hypertension later on in life, and it reduces the cost of food for the family and the country. Appropriate practices that support exclusive breastfeeding in the first six months reduce childhood morbidity and mortality. Aim: To assess mothers’ knowledge and practice of breastfeeding at El Sabbah Children’s hospital. Methodology: 384 mothers with children aged 9 to 12 months attending the immunization and paediatric outpatient clinics were interviewed. Statistical Package for Social Sciences (SPSS) was used for data handling. Descriptive statistics and univariate logistic regression were used to analyse the data. Results: The majority of mothers were aged between 21 – 25 years (43.5%), had 2 - 4 children (55.5%) and primary education (48.2%). Most mothers had started breastfeeding within the first hour of delivery (76.8%), and knew that breastfeeding was nutritious to the baby. Parity and mother`s level of education were significant factors associated with exclusive breastfeeding (p0.05). There was no statistical difference in rate of exclusive breastfeeding in mothers attending the OPD and the immunization clinic (p value=0.09). Conclusion: Most mothers knew the benefits and definitions of exclusive breastfeeding. The early measures supporting breastfeeding are well practiced. Parity and mothers` education significantly affected exclusive breastfeeding

Verbal autopsy: a tool for determining cause of death in a community

Verbal autopsy was used to determine causes of death in 239 Kenyan children under the age of 5 years. The diagnosis derived from verbal autopsy was corroborated with hospital diagnosis in 39 cases. There was concurrence of diagnosis in 72% of the cases. Using the diagnosis of bronchopneumonia to validate the method, verbal autopsy was found to have a sensitivity of 71%, specificity of 92%, and a positive predictive value of 85%. Recall period up to 29 months after death was found to be reliable

Patronage, district creation, and reform in Uganda

The effects of economic and political reforms on patronage in Africa remains unclear. In particular, there is much disagreement about whether structural adjustment programs and democratization have helped to make patronage less pervasive in African politics. Here, I examine the case study of Uganda, which has received much praise for its large-scale economic and political reforms since the late 1980s. However, at the same time, Uganda has also experienced a near-explosion in the number of districts (the highest level of local government), going from 39 to 80 in less than a decade. I examine a variety of potential reasons why these districts might have been created and argue, through the use of both qualitative and quantitative analysis, that district creation has functioned as a source of patronage. Specifically, I show that President Museveni_s government has created new districts as a means to compensate for other patronage resources lost through reforms and that new districts have helped him to continue to win elections. This paper thus constitutes the first rigorous demonstration that the creation of new sub-national political units can constitute a form of patronage and suggests that similar processes may be currently taking place across Afric